Individual provider Active NPI

Dennis Lee Keppeler, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1235326968
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014354 Issued in IL
Practice address
727 N Homan Ave
Chicago, IL 60624-1431
Phone
(708) 601-6122
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 149.014354 IL Primary

Addresses

Primary practice location

727 N Homan Ave
Chicago, IL 60624-1431

Mailing address

727 N Homan Ave
Chicago, IL 60624-1431
Phone (708) 601-6122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000149 IL Practitioner - Clinical Social Worker 1658513783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Clinical Services PCGroup PAC ID 0042374720, 18 clinicians

Practice addresses (Care Compare)

2340 S Highland Ave
Suite 300
Lombard, IL 60148-5397
Phone (630) 261-1210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014354ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 26, 2023 Accepting new patients

Locations

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

Interoperability endpoints

  • Direct secure messaging: dennis.keppeler.1@9265.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1235326968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 N HOMAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606241431",
            "telephone_number": "708-601-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N HOMAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606241431",
            "telephone_number": "708-601-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPPELER",
        "first_name": "DENNIS",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.